The Clinton administration's revised rules regulating but not prohibiting the common practice in managed care of linking physician compensation with cost cutting and control of services demonstrates the complexity of ethical issues in managed care. As originally proposed, the federal guidelines on payment for Medicare and Medicaid services would have precluded any interrelationship between payment to physicians and delivery of services. Such a restriction would have gutted the primary mechanism in managed care plans to curb the unacceptably high (...) cost of healthcare delivery: making physicians directly responsible for cost control by placing them at direct financial risk. At first blush such a linkage seems to involve an obvious and irreconcilable conflict of interest. How can a physician be responsible for the well-being of a patient while at the same time aware that a proportion of his or her income is linked to the provision of cost-conscious care? (shrink)

Health care costs and affordability are critical issues to consumers. Just as we assess the coverage impacts of a health reform proposal, we should be able to evaluate how the plan will constrain health care costs: its theory of cost control. This essay provides a framework to assess health reform plans on their theories of cost control, identifying the key policy tools to constrain health care costs organized in a two-by-two matrix across the following dimensions: price (...) vs. utilization and public vs. private payers. It then applies the framework to the Affordable Care Act and the Republican's 2017 legislative efforts to repeal and replace the ACA to identify their general theories of cost control, revealing on the plans' strengths, blind spots, and incoherence. (shrink)

Since the twentieth century, it has been an era of rapid development of information technology; the scale of data is almost the growth rate of the blowout type; no matter what it is, a large number of enterprises or departments are increasing a large number of cost data. However, the current cost management model still remains in the traditional management method and lacks a smarter big data analysis method. In addition, there is a lot of research on big (...) data applications, and there are few e-commerce supply chains. Therefore, the research purpose of this study is to use big data technology to explore a series of practical operation methods for supply chain Cultural Communication Enterprises and summarize the operation mode of building SCC control by using big data technology. In terms of research methods, this study combined bibliographic review and empirical analysis, explored cost-based mobile e-commerce cost control related to big data information, used smart and digital analysis methods to thoroughly analyze CCE business issues from internal and external supply chains, established an e-commerce business supply chain cost control model based on big data technology and elaborated cost control procedures and measures. Finally, it summarized the research results and drew conclusions to provide a theoretical basis for promoting enterprises products products to reduce supply chain costs. The research in this study has achieved a breakthrough in the cost management and control of EE; it provides empirical guidance and theoretical reference for EE to adopt big data technology for cost command of supply chain, could help EE to reduce cost of supply chain management to gain higher profit margins, and promote e-commerce industry as a whole to the next level eventually. This study concluded that the use of big data technology for cost command can solve a series of problems effectively, such as the lack of systematic analysis of cost, the lack of contractual partners, the serious waste of sales links, and the policy errors of logistics links, and continuously improve the enterprise management level and the decline of comprehensive cost. The application mode of supply chain CCE enterprises using big data technology constructed in this study has universal applicability. (shrink)

The “reproductive suppression hypothesis” states that the strong desire of adolescent girls in our culture to control their weight may reflect the operation of an adaptive mechanism by which ancestral women controlled the timing of their sexual maturation and hence first reproduction, in response to cues about the probable success of reproduction in the current situation. We develop a model based on this hypothesis and explore its behavior and evolutionary and psychological implications across a range of parameter values. We (...) use the process of model development to identify assumptions implicit in the reproductive suppression hypothesis and variables that need to be measured in order to investigate it more fully. In addition, because costs were probably associated with weight control, an important part of this analysis is the specification of situations in which the benefits of adaptive adjustment of the maturation schedule could have outweighed the costs of achieving that adjustment by slowing adolescent weight gain. (shrink)

This article addresses two components of the new governing architecture that help to reform the delivery of health care and to control costs of the health care system: the Center for Medicare and Medicaid Innovation and the Independent Payment Advisory Board. The republican controlled federal government has partially disassembled these two components, threatening the effectiveness of federal delivery system reform and cost control initiatives.

BackgroundIn the context of limited health care budgets in countries where Neglected Tropical Diseases (NTDs) are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost‐effectiveness analyses may lead to biased and insufficiently justified priorities.ObjectivesThe objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi‐criteria decision‐making matrix, and (...) 3) discuss the conditions under which this decision‐making procedure should be carried out in a real‐world decision‐making context.MethodsThis paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi‐criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases.DiscussionOur in vitro multi‐criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil‐transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision‐making process and we stress the limitations of this study exercise.ConclusionBy exploring how several criteria relevant to the multi‐facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)

Pharmacists, physicians, and other health care personnel practice within an integrated system of laws and regulations that influence many treatment modalities. Capitation, managed care, and other controls strain these relationships by mandating greater oversight of how health care is delivered. From a pharmacists’s perspective, any use of medication requites knowledge of three omnipresent factors: regulatory control, formularies, and economic decision making. My objective is to raise awareness of these issues as they relate to the prescription of pain medication and (...) to pain management generally.All practice-oriented drug law and regulation is based on the federal Controlled Substances Act of 1970. The Act, also known as Title II, is part of a much larger piece of legislation, the Comprehensive Drug Abuse Prevention and Control Act of 1970. CSA was enacted to regulate the manufacturing, distribution, dispensing, and delivery of drugs or substances that are subject to, or have the potential for, abuse or physical or psychological dependence. (shrink)

Pharmacists, physicians, and other health care personnel practice within an integrated system of laws and regulations that influence many treatment modalities. Capitation, managed care, and other controls strain these relationships by mandating greater oversight of how health care is delivered. From a pharmacists’s perspective, any use of medication requites knowledge of three omnipresent factors: regulatory control, formularies, and economic decision making. My objective is to raise awareness of these issues as they relate to the prescription of pain medication and (...) to pain management generally.All practice-oriented drug law and regulation is based on the federal Controlled Substances Act of 1970. The Act, also known as Title II, is part of a much larger piece of legislation, the Comprehensive Drug Abuse Prevention and Control Act of 1970. CSA was enacted to regulate the manufacturing, distribution, dispensing, and delivery of drugs or substances that are subject to, or have the potential for, abuse or physical or psychological dependence. (shrink)

Background In the context of limited health care budgets in countries where Neglected Tropical Diseases are endemic, scaling up disease control interventions entails the setting of priorities. However, solutions based solely on cost-effectiveness analyses may lead to biased and insufficiently justified priorities. Objectives The objectives of this paper are to 1) demonstrate how a range of equity concerns can be used to identify feasible priority setting criteria, 2) show how these criteria can be fed into a multi-criteria decision-making (...) matrix, and 3) discuss the conditions under which this decision-making procedure should be carried out in a real-world decision-making context. Methods This paper draws on elements from theories of decision analysis and ethical theories of fair resource allocation. We explore six typical NTD interventions by employing a modified multi-criteria decision analysis model with predefined criteria, drawn from a priority setting guide under development by the WHO. To identify relevant evidence for the six chosen interventions, we searched the PubMed and Cochrane databases. Discussion Our in vitro multi-criteria decision analysis suggested that case management for visceral leishmaniasis should be given a higher priority than mass campaigns to prevent soil-transmitted helminthic infections. This seems to contradict current health care priorities and recommendations in the literature. We also consider procedural conditions that should be met in a contextualised decision-making process and we stress the limitations of this study exercise. Conclusion By exploring how several criteria relevant to the multi-facetted characteristics of NTDs can be taken into account simultaneously, we are able to suggest how improved priority settings among NTDs can be realised. (shrink)

While it is true that health care costs are straining personal and governmental budgets, it does appear to be a manageable problem. There are tools available to moderate costs, efforts are already underway to control costs by modifying the financing of health care. Whether or not these will be effective remains to be seen. There also are efforts to control costs by modifying unhealthy habits. These efforts are showing notable success. Moreover, there are efforts underway to reduce health (...) care costs by altering the overall context of people's lives. This latter effort—to improve the health of whole communities—holds the greatest promise. (shrink)

In this work, a co-infection model for human papillomavirus and Chlamydia trachomatis with cost-effectiveness optimal control analysis is developed and analyzed. The disease-free equilibrium of the co-infection model is shown not to be globally asymptotically stable, when the associated reproduction number is less unity. It is proven that the model undergoes the phenomenon of backward bifurcation when the associated reproduction number is less than unity. It is also shown that HPV re-infection induced the phenomenon of backward bifurcation. Numerical (...) simulations of the optimal control model showed that: focusing on HPV intervention strategy alone, in the absence of C. trachomatis control, leads to a positive population level impact on the total number of individuals singly infected with C. trachomatis, Concentrating on C. trachomatis intervention controls alone, in the absence of HPV intervention strategies, a positive population level impact is observed on the total number of individuals singly infected with HPV. Moreover, the strategy that combines and implements HPV and C. trachomatis prevention controls is the most cost-effective of all the control strategies in combating the co-infections of HPV and C. trachomatis. (shrink)

The current paper studies guaranteed cost time-varying formation tracking design and analysis problems of high-order swarm systems subject to intermittent communications. Different from the existing work of the time-varying formation control, the time-varying formation tracking can be achieved while certain performance can be guaranteed, and the impacts of the intermittent communications and switching topologies are considered. First, a new intermittent time-varying formation tracking control protocol with a global performance index is proposed, where not only the formation regulation (...) performances but also the control energy expenditures are involved. The codesign of the gain matrix with the performance index is achieved to compromise the formation regulation performances against control energy expenditures, and the guaranteed cost is determined to restrain the upper bound of the performance index. Then, guaranteed cost time-varying formation tracking design and analysis criteria are given, where the matrix variable of the linear matrix inequality conditions is used to design the gain matrix and to determine the guaranteed cost. Finally, a simulation example is provided to illustrate the effectiveness of the theoretical results. (shrink)

Kurzban and colleagues carry forward an important contemporary movement in cognitive control research, tending away from resource-based models and toward a framework focusing on motivation or value. However, their specific proposal, centering on opportunity costs, appears problematic. We favor a simpler view, according to which the exertion of cognitive control carries intrinsic subjective costs.

Features of gait are determined at multiple levels, from the selection of the gait itself (e.g. walk or run) through the specific parameters utilized (stride length, frequency, etc.) to the pattern of muscular excitation. The ultimate choices are neurally determined, but what is involved with that decision process? Human locomotion appears stereotyped not so much because the pattern is predetermined, but because these movement patterns are good solutions for providing movement utilizing the machinery available to the individual (the legs and (...) their requisite components). Under different circumstances the appropriate solution may differ broadly (different gait) or subtly (different parameters). Interpretation of the neural decision making process would benefit from understanding the influences that determine the selection of the appropriate solution in any set of circumstances, including that of normal conditions. In this review we survey an array of studies that point to energetic cost as a key input to the gait coordination system, and not just an outcome of the gait pattern implemented. We then use that information to rigorously define the construct proposed by Sparrow and Newell (1998) where the effects of environment, organism and task act as constraints determining the solution set available, and the coordination pattern is then implemented under a pressure for energetic economy. Environment is defined in terms of affordances based on the ecological psychology definition of the concept and organism is defined as classic morphology and physiology based capabilities. We rely on a novel conceptualization of task that recognizes that the task goal needs to be separated from the mechanisms that achieve the goal if the motivation behind the selection of the mechanism strategy is to be exposed and understood. This reformulation of the Sparrow and Newell construct is then linked to the proposed pressure for economy by considering it as an optimization problem, where the most readily selected gait strategy will be that which achieves the task goal at (or near) the energetic minimum. (shrink)

In this paper, the issue of optimally modifying the structure of a directed network to guarantee its structural controllability is investigated. Given a directed network, in order to obtain a structurally controllable system, a framework for finding the minimum number of directed edges that need to be added to the network is proposed. After we get these edge-addition configurations, we further calculate the network cost of each optimization scheme and choose the one with the minimum cost. Our main (...) contribution is twofold: first, we provide an algorithm able to find all optimal network modifications in polynomial time; second, we provide a way to calculate the cost of optimizing the network based on the node betweenness. Numerical simulations are given to illustrate the theoretical results. (shrink)

I contend that Kurzban et al.'s model is silent on three issues. First, the extent to which opportunity-cost computations are automatic or deliberative is unclear. Second, the role of individual differences in biasing opportunity-cost computations needs elucidating. Third, in the absence of tasks, task persistence will be indefinite, which seems unfeasible, so perhaps integration with a limited-resource account is necessary.

Die Behandlung von einwilligungsunfähigen psychisch kranken Menschen mit neuen Therapiemethoden ist insbesondere im Kontext des „individuellen Heilversuchs“, der als Anwendung wenig erprobter Therapieansätze im Rahmen von „ultima ratio“-Entscheidungen charakterisiert ist, mit ethischen Abwägungsproblemen verbunden. Diese bestehen aufgrund von Einschränkungen in der Handlungs- und Entscheidungsautonomie der betroffenen Patienten und, aufgrund eigen- oder fremdgefährdender Symptome der psychischen Krankheit selbst, insbesondere in der praktischen Umsetzung ethisch akzeptierter Modelle stellvertretender Entscheidung sowie in der Wahl des Bezugspunkts der Nutzen-Risiko-Analyse des intendierten Therapieverfahrens. Der Artikel untersucht (...) den ethischen Konflikt zwischen gerechtfertigter Hilfeleistung und Instrumentalisierungsrisiko psychisch kranker Menschen zu Fremdzwecken am historischen Beispiel der „Rindenexcisionen“ des Psychiaters Gottlieb Burckhardt (1836–1907). Als Lösungsmöglichkeit dieses ethischen Konflikts wird das „Konzept des kontrollierten individuellen Heilversuchs“ diskutiert. (shrink)

Die Behandlung von einwilligungsunfähigen psychisch kranken Menschen mit neuen Therapiemethoden ist insbesondere im Kontext des „individuellen Heilversuchs“, der als Anwendung wenig erprobter Therapieansätze im Rahmen von „ultima ratio“-Entscheidungen charakterisiert ist, mit ethischen Abwägungsproblemen verbunden. Diese bestehen aufgrund von Einschränkungen in der Handlungs- und Entscheidungsautonomie der betroffenen Patienten und, aufgrund eigen- oder fremdgefährdender Symptome der psychischen Krankheit selbst, insbesondere in der praktischen Umsetzung ethisch akzeptierter Modelle stellvertretender Entscheidung sowie in der Wahl des Bezugspunkts der Nutzen-Risiko-Analyse des intendierten Therapieverfahrens. Der Artikel untersucht (...) den ethischen Konflikt zwischen gerechtfertigter Hilfeleistung und Instrumentalisierungsrisiko psychisch kranker Menschen zu Fremdzwecken am historischen Beispiel der „Rindenexcisionen“ des Psychiaters Gottlieb Burckhardt (1836–1907). Als Lösungsmöglichkeit dieses ethischen Konflikts wird das „Konzept des kontrollierten individuellen Heilversuchs“ diskutiert. (shrink)

Unmanned aerial vehicles, particularly quadcopters, have several medical, agriculture, surveillance, and security applications. However, the use of this innovative technology for civilian applications is still very limited in low-income countries due to the high cost, whereas low-cost controllers available in the market are often tuned using the hit and trial approach and are limited for specific applications. This paper addresses this issue and presents a novel proof of concept low-cost quadcopter UAV design approach using a systematic Model-Based (...) Design method for mathematical modeling, simulation, real-time testing, and prototyping. The quadcopter dynamic model is developed, and controllers are designed using Proportional Integral, and Derivative, Pole Placement, and Linear Quadratic Regulator control strategies. The stability of the controllers is also checked using Lyapunov stability analysis. For verification and validation of the design, Software-in-the-Loop, Processor-in-the-Loop, Hardware-in-the-loop testing, and Rapid Control Prototyping have been performed. The V&V methods of the MBD approach showed practically valid results with a stable flight of the quadcopter prototype. The proposed low-cost POC quadcopter design approach can be easily modified to have enhanced features, and quadcopters with different design parameters can be assembled using this approach for a diverse range of applications. (shrink)

As the price of pharmaceuticals and biologicals rises so does the number of patients who cannot afford them. In this article, we argue that physicians have a moral duty to help patients access affordable medicines. We offer three grounds to support our argument: (i) the aim of prescribing is to improve health and well-being which can only be realized with secure access to treatment; (ii) there is no morally significant difference between medicines being unavailable and medicines being unaffordable, so the (...) steps physicians are willing to take in the first case should extend to the second; and (iii) as the primary stakeholder with a duty to put the individual patient’s interests first, the medical professional has a duty to address cost-barriers to patient care. In articulating this duty, we take account of important epistemic and control conditions that must be met for the attribution of this duty to be justified. (shrink)

Purpose of review: What is the relationship between rationality and mental health? By considering the psychological literature on depressive realism and unrealistic optimism it was hypothesized that, in the context of judgments about the self, accurate cognitions are psychologically maladaptive and inaccurate cognitions are psychologically adaptive. Recent studies recommend being cautious in drawing any general conclusion about style of thinking and mental health. Recent findings: Recent investigations suggest that people with depressive symptoms are more accurate than controls in tasks involving (...) time perception and estimates of personal circumstances, but not in other tasks. Unrealistic optimism remains a robust phenomenon across a variety of tasks and domains, and researchers are starting to explore its neural bases. However, the challenge is to determine to what extent and in what way unrealistic optimism is beneficial. Summary: We should revisit the hypothesis that optimistic cognitions are psychologically adaptive, whereas realistic thinking is not. Realistic beliefs and expectations can be conducive to wellbeing and good functioning, and wildly optimistic cognitions have considerable psychological costs. (shrink)

Formal control systems are a common instrument to align employees’ interests with those of managers and companies. However, research shows that employees perceive formal controls as a sign of distrust and restraint, which can lead to costs of control in the form of lower employee cooperation and effort. We propose that charitable giving reduces these costs of control. We draw on the halo effect and propose that corporate charitable giving alters employees’ perception of and reaction to formal (...) controls. In a laboratory experiment, we find that charitable giving by a company creates a higher level of employee trust in a manager who decides to implement a control and a more positive assessment of formal control. These positive effects of charitable giving lead to lower costs of control compared to the absence of charitable giving. We thereby provide an example of how charitable giving as a corporate social responsibility activity yields positive benefits by altering the behavior of internal company stakeholders. (shrink)

The opportunity cost model offers an ultimate explanation of ego depletion that helps to move the field beyond biologically improbable resource accounts. The model's more proximate explanation, however, falls short of accounting for much data and is based on an outdated view of human rationality. We suggest that our own process model offers a better proximate account of self-control fatigue.

This paper uses the controversy over the denial of care on futility grounds as a window into the broader issue of the role of cost in decisions about treatment near the end of life. The focus is on a topic that has not received the attention it deserves: the difference between refusing medical treatment and demanding it. The author discusses health care reform and the ethics of cost control, arguing that we cannot achieve universal access to quality (...) care at affordable care without better public understanding of the moral legitimacy of taking cost into account in health care decisions, even decisions at the end of life. (shrink)

Self-control is a fundamental part of what it is to be a human being. It poses important philosophical and psychological questions about the nature of belief, motivation, judgment, and decision making. More immediately, failures of self-control can have high costs, resulting in ill-health, loss of relationships, and even violence and death, whereas strong self-control is also often associated with having a virtuous character. What exactly is self-control? If we lose control can we still be free? (...) Can we be held responsible for loss of self-control? -/- In this thorough and clearly written introduction to the philosophy of self-control, the authors examine and assess the following topics and questions: • The importance of self-control • What is self-control? • Self-control and the law of desire • Mechanisms of self-control • How is it possible to lose self-control? • Blameworthiness and (the loss of) self-control • Externalist self-control • Pathologies of self-control. -/- Combining philosophical analysis with surveys of the latest psychological research, and including chapter summaries, suggestions for further reading, and a glossary of key terms, Self-Control is essential reading for students of philosophy of mind and psychology, moral psychology, free will, and ethics. It will also be of interest to those in related fields such as psychology and cognitive science. (shrink)

AimTo examine the relative cost-effectiveness of predictive genetic tests for familial breast and ovarian cancer provided by Genetic Services of Western Australia.MethodsThe relative cost-effectiveness was assessed using a decision analytic model.ResultsThe cost and outcomes of genetic testing was compared in first-degree relatives of known BRCA1/2 mutation-carriers who have a 50% risk of carrying the mutated gene (intervention group) to individuals with the same a priori risk but who do not undergo a genetic test (control subjects).Since genetic (...) testing enables the restriction of intensive surveillance to individuals with an identified BRCA1/2 gene mutation, net savings in the period observed (age 25-70) were $980-$1008 per woman in the ovarian intervention group and $1681-$1795 per woman in the breast intervention group, and delayed the onset of breast cancer (6mths BRCA1, 3mths BRCA2).Compared to control subjects undergoing population surveillance, it was estimated the onset of breast cancer could be delayed at a total net cost of $3055 (5.1yrs) to $3389 (3.2yrs) for women in the breast intervention group with BRCA1/2 mutations. Since population surveillance is not currently recommended for ovarian cancer, control subjects undergoing no surveillance were compared with the intervention group. The onset of ovarian cancer was delayed at a net cost of $1630 (3.5yrs) to $2509 (1.2years) for women with BRCA1/2 mutations.ConclusionsTesting allows targeted high-level surveillance for gene mutation carriers, which ensures the cost-effective use of resources and reduces cancer-related morbidity if clinical recommendations for intervention are adopted. (shrink)

Since the last ice age, when ice enveloped most of the northern continents, the earth has warmed by about five degrees. Within a century, it is likely to warm by another four or five. This revolution in our climate will have immense and mostly harmful effects on the lives of people not yet born. We are inflicting this harm on our descendants by dumping greenhouse gases into the atmosphere. We can mitigate the harm a little by taking measures to (...) class='Hi'>control our emissions of these gases, and to adapt to the changes by, for instance, building sea walls around coastlines threatened by rising sea levels. But these measures will be very expensive, and the costs will be born by us, the present generation, whereas the benefits will come to future generations. How much should we sacrifice for the sake of the future? Economists and philosophers have independently worked on the question of our responsibility to future generations. This book brings their work together and applies it to global warming. It suggests a programme for future research on the economic and ethical issues. The book is intended for economists, and for philosophers and other social scientists who have a little knowledge of economic methods. (shrink)

Medicine and Money explores the role of beneficence and cost control in health-care systems. The book's primary concern of morally improving medicine is achieved by dividing the argument into two parts. The first defines the crisis in health-care and justifies beneficence. The second part offers practical suggestions on implementing beneficence into the system. Medicine and Money is one of the few books to provide concrete suggestions on improving the health-care system from the micro level for addressing cost (...) concerns in a morally acceptable manner. (shrink)

Cost–benefit analysis (CBA) is much more philosophically interesting than has in general been recognized. Since it is the only well-developed form of applied consequentialism, it is a testing-ground for consequentialism and for the counterfactual analysis that it requires. Ten classes of philosophical problems that affect the practical performance of cost–benefit analysis are investigated: topic selection, dependence on the decision perspective, dangers of super synopticism and undue centralization, prediction problems, the indeterminateness of our control over future decisions, the (...) need to exclude certain consequences for moral reasons, bias in the delimitation of consequences, incommensurability of consequences, difficulties in defending the essential requirement of transferability across contexts, and the normatively questionable but equally essential assumption of interpersonal compensability. (Published Online July 31 2007). (shrink)

In response to rapidly rising health care costs in the United States, federal and state governments and private industry are instituting numerous and diverse cost-containment plans. As devices for coping with a scarcity of resources, such plans present serious challenges to physicians' traditional single-minded devotion to patient welfare. Those which contain costs by directly limiting medical options or by controlling physicians' daily clinical decisions can threaten the quality of medical care by allowing economic authorities to make essentially medical judgments. (...) In contrast, other plans coax compliance by arranging incentives, e.g., offering financial rewards for successful cost containment. While they allow for clinical freedom, these plans create conflicts between physicians' fiduciary obligations to their patients and the competing interests of the payers. Such conflicts arise as physicians try to work within governmental or corporate cost containment policies, and also as they attempt to streamline clinical efficiency. Throughout, issues of justice emerge as physicians seek to reconcile their own patients' claims upon limited common resources with others' equally legitimate claims. (shrink)

Why does performing certain tasks cause the aversive experience of mental effort and concomitant deterioration in task performance? One explanation posits a physical resource that is depleted over time. We propose an alternative explanation that centers on mental representations of the costs and benefits associated with task performance. Specifically, certain computational mechanisms, especially those associated with executive function, can be deployed for only a limited number of simultaneous tasks at any given moment. Consequently, the deployment of these computational mechanisms carries (...) an opportunity cost – that is, the next-best use to which these systems might be put. We argue that the phenomenology of effort can be understood as the felt output of these cost/benefit computations. In turn, the subjective experience of effort motivates reduced deployment of these computational mechanisms in the service of the present task. These opportunity cost representations, then, together with other cost/benefit calculations, determine effort expended and, everything else equal, result in performance reductions. In making our case for this position, we review alternative explanations for both the phenomenology of effort associated with these tasks and for performance reductions over time. Likewise, we review the broad range of relevant empirical results from across sub-disciplines, especially psychology and neuroscience. We hope that our proposal will help to build links among the diverse fields that have been addressing similar questions from different perspectives, and we emphasize ways in which alternative models might be empirically distinguished. (shrink)

The cost of incongruent stimuli is reduced when conflict is expected. This series of experiments tested whether this improved performance is due to repetition priming or to enhanced cognitive control. Using a paradigm in which Word and Number Stroop alternated every trial, Experiment 1 assessed dynamic trial-to-trial changes. Incongruent trials led to task-specific reduction of conflict (trial n ϩ 2) without cross-task modulation (trial n ϩ 1), but this was fully explained by repetition priming. In contrast, an increased (...) ratio of incongruent words did lead to sustained task-specific enhancement, above and beyond.. (shrink)